A nurse is caring for a client who has developed a paralytic ileus related to acute pancreatitis and reports pain as 8 on a scale of 0 to 10. The client has prescriptions for multiple PRN pain medications. Which of the following medications should the nurse administer?

PO oxycodone

Ibuprofen via NG tube

IV hydromorphone

Topical lidocaine patch

Answer and Explanation

The Correct Answer is C

A. PO oxycodone: Oral medications are contraindicated in clients with paralytic ileus because of impaired gastrointestinal motility, which prevents proper absorption and increases the risk of gastric retention. IV administration is preferred for effective pain control in this scenario.

B. Ibuprofen via NG tube: NSAIDs can cause gastric irritation and increase the risk of gastrointestinal bleeding, especially in clients with pancreatitis. Additionally, an NG tube is not an appropriate route for medication administration in the presence of an ileus due to impaired intestinal function.

C. IV hydromorphone: IV opioids provide effective and rapid pain relief for clients with severe pain, especially when oral or enteral administration is not feasible. Hydromorphone is commonly used in acute pancreatitis because it controls pain effectively without exacerbating the underlying condition.

D. Topical lidocaine patch: While lidocaine patches provide localized pain relief, they are not sufficient for managing severe visceral pain associated with pancreatitis and ileus. Systemic analgesia via IV opioids is more appropriate for controlling this level of pain.

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Correct Answer is {"A":{"answers":"C"},"B":{"answers":"B"},"C":{"answers":"B"},"D":{"answers":"A,B,C"}}

Explanation

Sickle Cell Disease:
• Fatigue

Iron Deficiency Anemia:
• Ferritin level
• Fatigue
• Orthostatic hypotension

Pernicious Anemia:
• Vitamin B12 level
• Fatigue

Rationale:

• Vitamin B12 level: A decreased vitamin B12 level is characteristic of pernicious anemia, which results from impaired absorption of vitamin B12 due to intrinsic factor deficiency.

• Orthostatic hypotension: A drop in blood pressure upon standing is commonly seen in iron deficiency anemia due to reduced oxygen-carrying capacity and inadequate perfusion.

• Ferritin level: A low ferritin level indicates depleted iron stores, which is a hallmark of iron deficiency anemia.

• Fatigue: Fatigue is a common symptom in all three conditions due to reduced oxygen delivery to tissues. In sickle cell disease, fatigue results from chronic hemolysis and vaso-occlusive episodes. In iron deficiency anemia, it is caused by insufficient hemoglobin production. In pernicious anemia, fatigue results from ineffective erythropoiesis due to vitamin B12 deficiency.

A. Drink 3 L of fluids daily. B. Take a warm bubble bath daily. C. Drink low-fructose cranberry juice. D. Void every 6 hr during the day. E. Wipe the perineal area from front to back after urinating.

Correct Answer is ["A","C","E"]

Explanation

A. Drink 3 L of fluids daily: Increasing fluid intake helps flush bacteria from the urinary tract and dilutes urine, reducing the risk of infection. Adequate hydration also promotes more frequent urination, which prevents bacterial colonization in the bladder.

B. Take a warm bubble bath daily: Bubble baths can introduce irritants and disrupt the normal vaginal flora, increasing the risk of urinary tract infections. Soaking in bathwater containing soap or fragrances can also promote bacterial growth and irritation of the urethra.

C. Drink low-fructose cranberry juice: Cranberry juice contains compounds that help prevent bacteria, particularly Escherichia coli, from adhering to the bladder wall. Low-fructose options are preferred to minimize excessive sugar intake, which can contribute to bacterial growth.

D. Void every 6 hr during the day: Holding urine for long periods allows bacteria to multiply in the bladder, increasing the risk of infection. Voiding every 2 to 4 hours is recommended to promote bladder emptying and reduce bacterial colonization.

E. Wipe the perineal area from front to back after urinating: Wiping from front to back prevents the transfer of bacteria from the anal region to the urethra. This simple hygiene practice helps reduce the risk of E. coli contamination, a leading cause of urinary tract infections.

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A nurse is caring for a client who has developed a paralytic ileus related to acute pancreatitis and reports pain as 8 on a scale of 0 to 10. The client has prescriptions for multiple PRN pain medications. Which of the following medications should the nurse administer?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in a provider's office is caring for a client. For each client's finding, click to specify if the assessment finding is consistent with sickle cell disease, iron deficiency anemia, and/or pernicious anemia. Each finding may support more than 1 disease process.

Correct Answer is {"A":{"answers":"C"},"B":{"answers":"B"},"C":{"answers":"B"},"D":{"answers":"A,B,C"}}

Explanation

A nurse is teaching about measures to prevent recurring urinary tract infections with a female client. Which of the following information should the nurse include in the teaching? (Select all that apply.)

Correct Answer is ["A","C","E"]

Explanation

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